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Federal funding for biomedical and scientific research has long been a contentious government issue, with occasional dramatic flare-ups over the choice of grantees and the efficacy of their scientific methodology. But few doubt that the hundreds of billions of dollars spent over the years have frequently paid off with important medical and public health breakthroughs.

Recently, a five-year study financed by the National Institutes of Health (NIH) found that cutting-edge immunotherapy followed by stem cell transplantation proved highly effective in the treatment of a common form of multiple sclerosis (MS), a disease that attacks the central nervous system.

A team of researchers funded by NIH’s National Institute on Alcohol Abuse and Alcoholism recently reported developing techniques for preventing alcohol use among American Indian teenagers in northeastern Oklahoma. Another group of scientists funded by NIH’s National Cancer Institute and National Human Genome Research Institute made important genetic findings in the treatment of cervical cancer.

And other government-sponsored studies on how electric fields affect bacteria led to the development of an important cancer medicine called Cisplatin, which is used in the treatment of ovarian, breast, bladder and testicular cancer.

Basic government-sponsored research has provided an impressive return on investment, according to the National Institute of General Medical Sciences. “Regardless of what measure is used – reduced health care costs or increased productivity from longer, healthier lives – every dollar spent on basic research yield returns ranging from $10 to more than $80.”

After years of relatively flat funding of medical and scientific research, the Republican-controlled Congress approved a $2 billion increase in NIH’s annual budget a year ago and appeared on the verge of approving an additional $2 billion for the current fiscal year. But NIH’s future has been suddenly cast into doubt by the Trump Administration’s decision to seek a 19 percent cut in the agency’s $30.3 billion annual budget.

The $5.8 billion reductions in NIH funding for grants and aid is contained in the fiscal 2018 budget blueprint President Trump submitted to Congress on Thursday, which seeks draconian cuts in many federal agencies and programs to help offset a $54 billion increase in defense spending. Trump is seeking deep cuts in a wide array of scientific endeavors, particularly within the Environmental Protection Agency and other agencies engaged in climate change research.

The NIH is part of the Department of Health and Human Services, which came in for cuts of more than $15 billion or nearly 18 percent of its operating funds. Trump’s spending plan -- which is subject to review and alterations by lawmakers -- also calls for a “major reorganization” of NIH’s 27 institutes and centers. Moreover, it would abolish the Fogarty International Center, which funds research on global health needs and initiatives.

“Drastic cuts to the National Institutes of Health budget run counter to the priorities of our nation, national security, and the aspirations of Americans,” Mary Woolley, president and CEO of Research! America, a non-profit research and public advocacy group, said in a statement today. “Our nation was built on hard work, a determination to create a better future for our children, and empathy, not apathy, in the face of human suffering. This budget proposal cuts life-saving research and public health services that are fundamental to that vision.”

More than 80 percent of NIH’s funding is awarded through nearly 50,000 competitive grants to more than 300,000 researchers at more than 2,500 universities, medical schools and other research institutions throughout the country. About 10 percent of NIH's budget supports projects conducted by nearly 6,000 scientists in its own laboratories, which are primarily located on the agency’s campus in Bethesda, Maryland.

Between fiscal 2003 and 2015, NIH fell into political disfavor and lost 22 percent of its capacity to fund research projects because of budget cuts, sequestration and inflationary losses. As the money dried up, NIH was forced to scale back its grant-making and other research activity substantially.

But that began to turn around a year ago when a bipartisan coalition got behind increased funding for the agency. Even one of Trump’s senior campaign advisers, former House Speaker Newt Gingrich (R-GA), called for a doubling of the agency’s budget as a moral and financial imperative. Dr. Francis Collins, the director of the NIH, told reporters at the time that he was optimistic that funding in the future would be predictable and on the upswing.

Three senior Republicans on key committees with spending authority and oversight over NIH played critical roles -- Sens. Roy Blunt (MO) and Lamar Alexander (TN) and Rep. Tom Cole of Oklahoma. Together, they helped push Congress to take a first big step in bolstering funding for NIH with a $2 billion increase in fiscal 2016.

The Senate recommended another $2 billion increase in the current fiscal year that runs through Sept. 30. However, Congress has yet to complete work on this year’s spending measures, and Trump’s budget plan could put a damper on additional funding for the agency.

Much will depend on the determination of NIH’s allies on Capitol Hill. Cole, who is chairman of an appropriation subcommittee with jurisdiction over NIH, told the on-line health care publication STAT earlier this month that he hoped to increase the agency’s funding by as much as $2 billion this year.

And Blunt issued a statement yesterday, cautioning that Trump’s proposed discretionary spending cuts were merely the first step in a long legislative process and making it clear Trump hasn’t made an adequate case yet for such dire cuts.

"The president’s budget is the first step in the appropriations process,” Blunt said. “There are many concerns with non-defense discretionary cuts. Over the next several weeks, we’ll be holding hearings with cabinet secretaries and others involved to determine funding priorities for fiscal year 2018."

Washington Editor and D.C. Bureau Chief Eric Pianin is a veteran journalist who has covered the federal government, congressional budget and tax issues, and national politics. He spent over 25 years at The Washington Post.